Palonosetron was greater than first-generation 5-HT3 receptor antagonists in the prevention of nausea and vomiting have been established in many systematic reviews. However, several recent randomized control trials manifested inconsistent results. Thus, we conducted a systematic review to evaluate the efficacy and safety of palonosetron versus granisetron in chemotherapy induced nausea and vomiting (CINV).
The PubMed, Embase, and The Cochrane Library databases were searched for studies published before April 2020. The meta-analysis was performed to estimate the pooled effect sizes by using a random effect model. The primary outcome was treatment responses of CINV (complete response rate, complete control rate, and total control rate). Secondary outcomes were 5-HT3 receptor antagonist related common side effects (constipation, and headache).
Twelve randomized controlled trials, three prospective studies and one retrospective study were reviewed. Palonosetron was consistently statistically superior in any phase of complete response rate (acute phases: odds ratio [OR]= 1.37, 95% confidence interval [CI]: 1.03 to 1.82; delayed phases: OR= 1.57, 95% CI: 1.15 to 2.15; overall phases: OR= 1.37, 95% CI: 1.17 to 1.60), delayed phases of complete control rate and total control rate (OR= 1.45, 95% CI: 1.23 to 1.72; OR= 1.29, 95% CI: 1.01 to 1.65, respectively). Subgroup analysis indicated that there was no significant difference between palonosetron and granisetron in any phase of complete response when combined with NK1 antagonists. No statistically significant difference was found between constipation and diarrhea toxicities of the two groups.
Although palonosetron significantly decreased the risk of chemotherapy induced nausea and vomiting in any phase, granisetron is seeming comparable effectiveness with palonosetron when adding NK1 antagonists.
The authors.
Has not received any funding.
All authors have declared no conflicts of interest.